What it is
Coronary CT angiography (CCTA) uses a CT scanner and an iodine-based contrast dye, given through a vein in the arm, to create detailed images of the coronary arteries, the vessels that supply the heart muscle. It can show plaque, including plaque that has not yet caused symptoms, and how much an artery is narrowed. It is non-invasive: no catheter is passed into the heart.
FFR-CT (fractional flow reserve derived from CT) is an additional analysis of the same images. Computer modelling estimates whether a particular narrowing is likely to limit blood flow to the heart muscle. That helps separate narrowings that may need further testing or treatment from those that can usually be managed with medication and prevention. FFR-CT needs no extra scan, but it is not required after every CCTA and cannot be performed on every set of images.
Who it may suit
CCTA is most often used to evaluate chest discomfort or other symptoms that could come from the heart, and it is included in the 2021 AHA/ACC guideline for the evaluation of chest pain. In selected people without symptoms, it may help clarify risk when the answer would change treatment. It is not a routine screening test for everyone, and Dr. Siddiqui will discuss whether it, a coronary calcium score, a stress test or no test at all is the better choice for you.
What to expect
The scan is performed at an accredited imaging facility and takes only a few minutes on the table, though the visit is longer. You may be asked to avoid caffeine beforehand, and medication is sometimes given to slow the heart rate so that the images are sharp. Kidney function and any history of contrast allergy are checked first. The scan uses a modest dose of radiation, which is weighed against the value of the information.
Dr. Siddiqui reviews the results with you and explains what they mean for prevention, medication or further evaluation. Chest pain that is new, severe or ongoing needs emergency care: call 911.
Request a consultation
To discuss whether coronary CT angiography is the right test for you, email the practice to arrange a conversation. Please do not include medical records or sensitive health information in ordinary email.
Imaging and laboratory tests are generally billed separately from membership; please ask about coverage and costs before testing.
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About Dr. Siddiqui. Dr. Irfan Siddiqui provides concierge care through Regenerative Health & Wellness. More about Dr. Siddiqui · Explore membership.